移植后由医生指导的mycophenolate mofetil剂量减少:一个多中心的真实文字体验
Hani M Wadei1, Namrata Parikh1, Sarah Suliman1
1Department of Transplant, Mayo Clinic, Jacksonville, Florida.
Transplantation proceedings
|December 5, 2024
概括
在移植 (KT) 后降低mycophenolate mofetil (MMF) 剂量是常见的和安全的. 这项研究发现,在减少MMF剂量的情况下,患者或移植存活率没有差异,这表明MMF剂量减少在KT后可能是安全的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫抑制是一种免疫抑制.
- 移植 移植 移植 移植
背景情况:
- 在移植 (KT) 后,经常会减少甲酸莫菲蒂尔 (MMF) 的剂量.
- 货币市场基金剂量减少对长期KT结果的影响尚不清楚.
研究的目的:
- 调查MMF剂量减少与脏移植接受者移植后长达5年的临床结果之间的关联.
- 为了确定较低的MMF剂量是否会影响排斥率,移植存活率或患者存活率.
主要方法:
- 在2012年2月至2015年2月期间,对432名移植患者进行了回顾性分析.
- 患者接受了标准免疫抑制药物,包括氨氨酸抑制剂和MMF (1.5-2g/天) 含或不含普德尼松.
- 根据临床指示或酸 (MPA) 水平调整了MMF剂量;在1年和5年评估结果,包括协议活检和供体特异性抗体 (DSA) 评估.
主要成果:
- 一年后,49%的接受者因临床原因或MPA水平升高而接受低剂量MMF (≤1g/天).
- 在1年后,低MMF和标准MMF组之间没有观察到排斥率,炎症或DSA形成的显著差异.
- 5年后,69%的人服用低剂量的MMF,患者和死亡审查的移植存活率在组之间相似.
结论:
- 近50%的脏移植接受者在第一年内使用低剂量的MMF,随着时间的推移而增加.
- 医生指导的MMF剂量减少似乎是安全的,对关键的临床结果没有不利影响.
- 需要进一步的随机对照试验来确认减少MMF剂量策略的安全性和有效性.
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